Elbeuf

Researchers are evaluating the effectiveness of different antimicrobial treatments for infections caused by difficult-to-treat Pseudomonas aeruginosa bacteria. This infection is especially challenging for patients who are critically ill or have weakened immune systems. The study focuses on comparing new beta-lactam/beta-lactamase inhibitor combinations, cefiderocol, and older drugs like aminoglycosides and colistin in real-life clinical settings across multiple hospital centers in France. Participants will receive intravenous antimicrobial therapy tailored to treat their difficult-to-treat P. aeruginosa infection. The study observes the use of new and older antimicrobial drugs to assess their clinical efficacy. Patient data and bacterial samples will be collected and analyzed centrally to better understand drug resistance mechanisms and treatment outcomes. Participants will be monitored for clinical cure shortly after completing therapy and on Day 7 ± 2 days. Researchers will collect clinical information through electronic case-report forms and send bacterial isolates to a national center for detailed testing. Outcomes include cure rates, resistance development, adverse events, and mortality rates, with follow-up during hospitalization and up to 28 days after treatment. The study aims to provide valuable real-world data on treating these challenging infections.

Gout is a common inflammatory condition caused by high levels of uric acid that leads to painful joint attacks and can result in chronic joint damage, kidney problems, and increased heart risks. This study evaluates whether starting the gout treatment febuxostat immediately during an acute attack is as safe and effective as delaying treatment by six weeks, which is the current recommendation. The trial aims to compare these two approaches in patients diagnosed with gout attacks, focusing on treatment timing and its impact on the disease progression and symptoms. Participants are randomly assigned to two groups: one receives febuxostat 80 mg daily immediately for six weeks, while the other waits six weeks before starting the same treatment. After this initial six-week period, all patients receive febuxostat for an additional six weeks in an extension phase. The study also includes follow-up visits at three and six months to assess ongoing treatment effects. The febuxostat dose does not require adjustment for patients with moderate kidney function (creatinine clearance above 30 ml/min). During the study, patients track the number of days with gout symptoms daily using a booklet and report their pain and overall condition through questionnaires. Doctors perform clinical exams and monitor joint health, blood pressure, and any side effects. Laboratory tests at six and twelve weeks include uric acid, kidney and liver function, inflammation markers, and blood counts to assess treatment safety and effectiveness. The study lasts up to six months with regular assessments to monitor gout attacks and treatment tolerance.

This prospective multicenter registry will evaluate the long-term electrical, echocardiographic, and clinical outcomes of conduction system pacing (CSP). There is currently limited data in the literature regarding the long-term results and benefits of CSP. The long-term maintenance of conduction system (His bundle or Left Bundle Branch) capture and physiological ventricular activation is an essential prerequisite for the expected benefits of this technique. There is currently no prospective study evaluating the preservation of CSP during long-term follow-up. The design of the present study will allow reliable evaluation of CSP maintenance at 2 years follow-up. The prospective collection of electrical data (pacing thresholds, impedance, R wave sensing) during pacemaker follow-up visits will confirm thresholds stability over the long term. The incidence of atrial fibrillation episodes will also be precisely evaluated and will provide new information. Although pathophysiological studies have demonstrated less impairment of left atrial function with conduction system pacing, there is currently no data on the incidence of atrial fibrillation in patients implanted with a CSP pacemaker. Echocardiographic data will be prospectively collected in order to analyse the evolution of left ventricular ejection fraction (LVEF) after CSP. This systematic follow-up is rarely found in CSP studies, often retrospective, with significant missing echocardiographic data. The hypothesis is that patients benefiting from CSP will not develop the deleterious effects demonstrated with conventional right ventricular pacing, such as left ventricular dilation and LVEF impairment. Inter- and intraventricular asynchrony criteria will also be systematically evaluated during follow-up echocardiography.Finally, this prospective cohort will also systematically collect clinical follow-up data (hospitalizations for heart failure and NYHA stage).

Researchers are studying patients who have metastatic lung cancer and have survived for more than three years after their diagnosis without receiving cytotoxic chemotherapy. The focus is on understanding their clinical features, health status, quality of life, and socio-economic impacts, including the effects of cancer treatments, the occurrence of new diseases, and return to work. This observational study aims to better identify the needs of these long-term survivors to improve their management. Participants will complete several questionnaires, including the Hospital Anxiety and Depression Scale (HAD), the Quality of Life Questionnaire - Lung Cancer 13 (QLQ-LC13), and the Aix-Marseille-University (AMU) questionnaire. These are designed to assess anxiety, depression, lung cancer symptoms, treatment side effects, and overall quality of life. Questionnaires are completed at the start of the study, at 6 and 12 months, and then yearly for up to 5 years. Participants will be followed during their regular medical consultations as per usual care at participating centers. Throughout the study, researchers will collect information on clinical characteristics, treatment details, health status, socio-demographic factors, and quality of life measures. Data will be gathered at baseline and during follow-up visits up to 5 years. This information will help assess the long-term impact of lung cancer and its treatments on patients who are living well beyond initial expectations.

Researchers are gathering real-world data on patients aged 70 years and older who are receiving first-line treatment for thoracic tumors, specifically Non-Small-Cell Lung Carcinoma (NSCLC). This Phase 4 study aims to characterize patients in terms of their geriatric, biological, and cancer-related features. It will also describe treatment methods by disease stage and evaluate outcomes related to treatment effectiveness, safety, and quality of life. Subgroups of patients treated with the same medication or innovative strategies will also be explored. Participants will receive systemic treatments that are authorized and available through standard care or compassionate use. Blood samples will be collected before starting treatment and stored in a biobank for up to 10 years. Quality of life will be assessed using specific questionnaires at various time points depending on disease stage and treatment type. Geriatric assessments including autonomy scales, cognitive tests, depression screening, fall history, and social environment evaluations will be performed. During the study, participants will follow their usual clinical care with regular visits, laboratory tests, imaging, and biopsies as needed to monitor their general health, treatment effectiveness, and side effects. They will complete quality of life questionnaires and undergo assessments tailored for older adults. Researchers will measure progression-free survival, defined as the time from first treatment dose until disease progression or death, with follow-up lasting up to two years.

Colorectal cancer mainly affects elderly patients, with over half of new cases in France occurring in those aged 70 or older. Adjuvant chemotherapy has shown benefits in disease-free and overall survival after stage III colon cancer surgery, but its use in elderly patients remains limited. This phase III randomized study explores whether adjuvant chemotherapy improves disease-free survival in elderly patients and which chemotherapy regimen is most effective, addressing concerns about benefits for both unfit and fit elderly patients. Participants will be divided into two groups based on a multidisciplinary evaluation including a geriatrician. One group will receive fluoropyrimidine-based chemotherapy (LV5FU2 or capecitabine), and the other will receive oxaliplatin-based chemotherapy (FOLFOX4 or XELOX). Some patients may be assigned to observation only. Treatments will begin within 12 weeks after surgery. The study also evaluates specific biological markers common in elderly tumors, such as mismatch repair deficiency. During the study, participants will undergo assessments including geriatric questionnaires and medical monitoring. Researchers will track disease-free survival over three years following the last patient's enrollment. Safety and treatment effects will be monitored, with exclusion of patients expected to live less than four years or those unable to comply with follow-up. The study aims to better understand chemotherapy benefits in an elderly population after colon cancer surgery.

Researchers are evaluating a screening method for hepatitis B, hepatitis C, and AIDS viruses among drug users. The study aims to identify active infections of these viruses using a simple blood collection technique. It focuses on individuals with a history of intravenous or nasal drug use, including those receiving opiate substitution therapy. The study uses a Dried Blood Spot method for blood collection to screen participants for hepatitis B, hepatitis C, and AIDS viruses. This approach allows for easier sample collection and testing in this population. The intervention involves collecting blood samples on special filter paper to detect active infections. Participants are involved in one screening visit where their blood is collected using the Dried Blood Spot method. Researchers will assess the presence of active hepatitis B, hepatitis C, and AIDS infections on the first day. The study monitors the number of individuals with active infections as primary outcomes. The total participation time is focused on this initial screening event.